About the Project
The Cambodia Integrated HIV and Drug Prevention Implementation Program (CIPI) will assess the impact of an intervention designed to reduce HIV risk and amphetamine-type substance (ATS) use among Cambodian female entertainment and sex workers (FESW). Building upon FHI 360’s SMARTgirl program, SMARTgirl Plus will consist of the existing program plus a conditional cash transfer program for ATS users and a microfinance program opportunity for women who are ATS free. Using a stepped wedge randomised cluster design, we will evaluate whether SMARTgirl Plus, implemented in 10 provinces over 30 months, results in larger decreases in HIV risk compared to standard SMARTgirl. Secondary outcomes include ATS use, uptake of HIV prevention and reproductive health services and financial and gender empowerment. Qualitative research exploring experiences and views of participants and staff in the pre and post intervention periods will complement the quantitative analyses.
Our previous research with Cambodian FESW documented high prevalence of HIV and ATSuse and identified ATS use as a key driver of HIV risk. Currently, no HIV prevention interventions in Cambodia target ATS use among FESWs.
The primary aim of CIPI is to assess the impact of a new intervention designed to reduce HIV risk and ATS use among Cambodian FESWs. A secondary aim involves the establishment of an HIV Implementation Science Collaborative (HISC) in Cambodia. The HISC will link a range of governmental, academic and community-based stakeholders in order to advance translational aspects of HIV prevention research in Cambodia.
Design & Method
CIPI consists of a stepped-wedge randomized cluster trial assessing the efficacy of a 12 week Conditional Cash Transfer (CCT) intervention followed by a 4 week group-based after care component in reducing HIV risk and ATS use among FESWs. The intervention will be randomly rolled out in ten provinces (clusters). Implementation and evaluation will occur over fouryears, resulting in all clusters receiving the intervention. Analyses will be carried out on the individual level accounting for correlation through generalized estimating equations (GEE). We will also conduct in-depth qualitative interviews at pre and post-intervention implementation time-points.
The trial will produce new knowledge and potential improvements to HIV prevention practice in Cambodia and provide a model for implementation science projects within the region and globally.
Peer-reviewed publications, conference presentations and reports
Professor and Program Head and NHMRC Senior Research Fellow
Ph +61 (2) 9385 0936
Kimberly Page, Adam Carrico, Ellen Stein, Chhit Sophal, Song Ngak
Project Collaborators: External
University of California, San Francisco